Is age a prognostic biomarker for survival among women with locally advanced cervical cancer treated with chemoradiation? An NRG Oncology/Gynecologic Oncology Group ancillary data analysis

Kathleen N. Moore, James J. Java, Katrina N. Slaughter, Peter G. Rose, Rachelle Lanciano, Paul A. DiSilvestro, J. Tate Thigpen, Yi Chun Lee, Krishnansu S. Tewari, Junzo Chino, Shelly M. Seward, David S. Miller, Ritu Salani, David H. Moore, Frederick B. Stehman

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective To determine the effect of age on completion of and toxicities following treatment of local regionally advanced cervical cancer (LACC) on Gynecologic Oncology Group (GOG) Phase I–III trials. Methods An ancillary data analysis of GOG protocols 113, 120, 165, 219 data was performed. Wilcoxon, Pearson, and Kruskal-Wallis tests were used for univariate and multivariate analysis. Log rank tests were used to compare survival lengths. Results One-thousand-three-hundred-nineteen women were included; 60.7% were Caucasian, 15% were age 60–70 years and an additional 5% were > 70; 87% had squamous histology, 55% had stage IIB disease and 34% had IIIB disease. Performance status declined with age (p = 0.006). Histology and tumor stage did not significantly differ. Number of cycles of chemotherapy received, radiation treatment time, nor dose modifications varied with age. Notably, radiation protocol deviations and failure to complete brachytherapy (BT) did increase with age (p = 0.022 and p < 0.001 respectively). Only all grade lymphatic (p = 0.006) and grade ≥ 3 cardiovascular toxicities (p = 0.019) were found to vary with age. A 2% increase in the risk of death for every year increase > 50 for all-cause mortality (HR 1.02; 95% CI, 1.01–1.04) was found, but no association between age and disease specific mortality was found. Conclusion This represents a large analysis of patients treated for LACC with chemo/radiation, approximately 20% of whom were > 60 years of age. Older patients, had higher rates of incomplete brachytherapy which is not explained by collected toxicity data. Age did not adversely impact completion of chemotherapy and radiation or toxicities.

Original languageEnglish (US)
Pages (from-to)294-301
Number of pages8
JournalGynecologic Oncology
Volume143
Issue number2
DOIs
StatePublished - Nov 1 2016

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Uterine Cervical Neoplasms
Biomarkers
Radiation
Survival
Brachytherapy
Histology
Drug Therapy
Mortality
Multivariate Analysis
Therapeutics
Neoplasms

Keywords

  • Biomarkers
  • Cervical cancer
  • Chemoradiation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Is age a prognostic biomarker for survival among women with locally advanced cervical cancer treated with chemoradiation? An NRG Oncology/Gynecologic Oncology Group ancillary data analysis. / Moore, Kathleen N.; Java, James J.; Slaughter, Katrina N.; Rose, Peter G.; Lanciano, Rachelle; DiSilvestro, Paul A.; Thigpen, J. Tate; Lee, Yi Chun; Tewari, Krishnansu S.; Chino, Junzo; Seward, Shelly M.; Miller, David S.; Salani, Ritu; Moore, David H.; Stehman, Frederick B.

In: Gynecologic Oncology, Vol. 143, No. 2, 01.11.2016, p. 294-301.

Research output: Contribution to journalArticle

Moore, KN, Java, JJ, Slaughter, KN, Rose, PG, Lanciano, R, DiSilvestro, PA, Thigpen, JT, Lee, YC, Tewari, KS, Chino, J, Seward, SM, Miller, DS, Salani, R, Moore, DH & Stehman, FB 2016, 'Is age a prognostic biomarker for survival among women with locally advanced cervical cancer treated with chemoradiation? An NRG Oncology/Gynecologic Oncology Group ancillary data analysis', Gynecologic Oncology, vol. 143, no. 2, pp. 294-301. https://doi.org/10.1016/j.ygyno.2016.08.317
Moore, Kathleen N. ; Java, James J. ; Slaughter, Katrina N. ; Rose, Peter G. ; Lanciano, Rachelle ; DiSilvestro, Paul A. ; Thigpen, J. Tate ; Lee, Yi Chun ; Tewari, Krishnansu S. ; Chino, Junzo ; Seward, Shelly M. ; Miller, David S. ; Salani, Ritu ; Moore, David H. ; Stehman, Frederick B. / Is age a prognostic biomarker for survival among women with locally advanced cervical cancer treated with chemoradiation? An NRG Oncology/Gynecologic Oncology Group ancillary data analysis. In: Gynecologic Oncology. 2016 ; Vol. 143, No. 2. pp. 294-301.
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abstract = "Objective To determine the effect of age on completion of and toxicities following treatment of local regionally advanced cervical cancer (LACC) on Gynecologic Oncology Group (GOG) Phase I–III trials. Methods An ancillary data analysis of GOG protocols 113, 120, 165, 219 data was performed. Wilcoxon, Pearson, and Kruskal-Wallis tests were used for univariate and multivariate analysis. Log rank tests were used to compare survival lengths. Results One-thousand-three-hundred-nineteen women were included; 60.7{\%} were Caucasian, 15{\%} were age 60–70 years and an additional 5{\%} were > 70; 87{\%} had squamous histology, 55{\%} had stage IIB disease and 34{\%} had IIIB disease. Performance status declined with age (p = 0.006). Histology and tumor stage did not significantly differ. Number of cycles of chemotherapy received, radiation treatment time, nor dose modifications varied with age. Notably, radiation protocol deviations and failure to complete brachytherapy (BT) did increase with age (p = 0.022 and p < 0.001 respectively). Only all grade lymphatic (p = 0.006) and grade ≥ 3 cardiovascular toxicities (p = 0.019) were found to vary with age. A 2{\%} increase in the risk of death for every year increase > 50 for all-cause mortality (HR 1.02; 95{\%} CI, 1.01–1.04) was found, but no association between age and disease specific mortality was found. Conclusion This represents a large analysis of patients treated for LACC with chemo/radiation, approximately 20{\%} of whom were > 60 years of age. Older patients, had higher rates of incomplete brachytherapy which is not explained by collected toxicity data. Age did not adversely impact completion of chemotherapy and radiation or toxicities.",
keywords = "Biomarkers, Cervical cancer, Chemoradiation",
author = "Moore, {Kathleen N.} and Java, {James J.} and Slaughter, {Katrina N.} and Rose, {Peter G.} and Rachelle Lanciano and DiSilvestro, {Paul A.} and Thigpen, {J. Tate} and Lee, {Yi Chun} and Tewari, {Krishnansu S.} and Junzo Chino and Seward, {Shelly M.} and Miller, {David S.} and Ritu Salani and Moore, {David H.} and Stehman, {Frederick B.}",
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T1 - Is age a prognostic biomarker for survival among women with locally advanced cervical cancer treated with chemoradiation? An NRG Oncology/Gynecologic Oncology Group ancillary data analysis

AU - Moore, Kathleen N.

AU - Java, James J.

AU - Slaughter, Katrina N.

AU - Rose, Peter G.

AU - Lanciano, Rachelle

AU - DiSilvestro, Paul A.

AU - Thigpen, J. Tate

AU - Lee, Yi Chun

AU - Tewari, Krishnansu S.

AU - Chino, Junzo

AU - Seward, Shelly M.

AU - Miller, David S.

AU - Salani, Ritu

AU - Moore, David H.

AU - Stehman, Frederick B.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objective To determine the effect of age on completion of and toxicities following treatment of local regionally advanced cervical cancer (LACC) on Gynecologic Oncology Group (GOG) Phase I–III trials. Methods An ancillary data analysis of GOG protocols 113, 120, 165, 219 data was performed. Wilcoxon, Pearson, and Kruskal-Wallis tests were used for univariate and multivariate analysis. Log rank tests were used to compare survival lengths. Results One-thousand-three-hundred-nineteen women were included; 60.7% were Caucasian, 15% were age 60–70 years and an additional 5% were > 70; 87% had squamous histology, 55% had stage IIB disease and 34% had IIIB disease. Performance status declined with age (p = 0.006). Histology and tumor stage did not significantly differ. Number of cycles of chemotherapy received, radiation treatment time, nor dose modifications varied with age. Notably, radiation protocol deviations and failure to complete brachytherapy (BT) did increase with age (p = 0.022 and p < 0.001 respectively). Only all grade lymphatic (p = 0.006) and grade ≥ 3 cardiovascular toxicities (p = 0.019) were found to vary with age. A 2% increase in the risk of death for every year increase > 50 for all-cause mortality (HR 1.02; 95% CI, 1.01–1.04) was found, but no association between age and disease specific mortality was found. Conclusion This represents a large analysis of patients treated for LACC with chemo/radiation, approximately 20% of whom were > 60 years of age. Older patients, had higher rates of incomplete brachytherapy which is not explained by collected toxicity data. Age did not adversely impact completion of chemotherapy and radiation or toxicities.

AB - Objective To determine the effect of age on completion of and toxicities following treatment of local regionally advanced cervical cancer (LACC) on Gynecologic Oncology Group (GOG) Phase I–III trials. Methods An ancillary data analysis of GOG protocols 113, 120, 165, 219 data was performed. Wilcoxon, Pearson, and Kruskal-Wallis tests were used for univariate and multivariate analysis. Log rank tests were used to compare survival lengths. Results One-thousand-three-hundred-nineteen women were included; 60.7% were Caucasian, 15% were age 60–70 years and an additional 5% were > 70; 87% had squamous histology, 55% had stage IIB disease and 34% had IIIB disease. Performance status declined with age (p = 0.006). Histology and tumor stage did not significantly differ. Number of cycles of chemotherapy received, radiation treatment time, nor dose modifications varied with age. Notably, radiation protocol deviations and failure to complete brachytherapy (BT) did increase with age (p = 0.022 and p < 0.001 respectively). Only all grade lymphatic (p = 0.006) and grade ≥ 3 cardiovascular toxicities (p = 0.019) were found to vary with age. A 2% increase in the risk of death for every year increase > 50 for all-cause mortality (HR 1.02; 95% CI, 1.01–1.04) was found, but no association between age and disease specific mortality was found. Conclusion This represents a large analysis of patients treated for LACC with chemo/radiation, approximately 20% of whom were > 60 years of age. Older patients, had higher rates of incomplete brachytherapy which is not explained by collected toxicity data. Age did not adversely impact completion of chemotherapy and radiation or toxicities.

KW - Biomarkers

KW - Cervical cancer

KW - Chemoradiation

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